Surgical Repair Using Suture Bridge Technique for Triceps Tendon Avulsion

Triceps tendon avulsion is a rarely occurring tendinous injury. Various surgical procedures, such as repair using sutures through the transosseous tunnel or suture anchors, have been reported for treating triceps tendon avulsion. However, standard surgical treatment has not yet been established. Here, we present a case of triceps tendon avulsion treated using the suture bridge technique. A 58-year-old man who fell on his left elbow from standing height presented to our hospital. Plain radiography revealed an avulsion fracture of the left olecranon process, suggesting triceps tendon avulsion. We performed surgical repair of the avulsed bone fragments and ruptured triceps tendon. We inserted suture anchors into the ulna, proximal to the fracture site, and passed the sutures through the full thickness of the triceps. Subsequently, fracture fragments were reduced and fixed by pulling them together with the triceps. We inserted knotless anchors into the ulna distal to the fracture site and fixed the avulsed bone fragments and triceps tendon using the suture bridge technique. The patient recovered well in five months and reported no elbow pain or limited range of motion. This suture bridge technique is advantageous as it prevents iatrogenic fracture and knot irritation, and it would be indicated in cases with poor bone quality or thin skin soft tissue of the olecranon.

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Surgical Repair of an Acute Latissimus Dorsi Tendon Avulsion Using Suture Anchors through a Single Incision

The American Journal of Sports Medicine ◽

10.1177/0363546506286787 ◽

2006 ◽

Vol 34 (8) ◽

pp. 1351-1355 ◽

Cited By ~ 24

Author(s):

Jit-Kheng Lim ◽

Michelle E. Tilford ◽

Scott F. Hamersly ◽

Peter I. Sallay

Keyword(s):

Latissimus Dorsi ◽

Surgical Repair ◽

Single Incision ◽

Suture Anchors ◽

Tendon Avulsion

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Surgical repair of isolated triceps tendon rupture using a suture anchor technique: a case report

Joints ◽

10.11138/jts/2016.4.4.250 ◽

2016 ◽

Vol 04 (04) ◽

pp. 250-252 ◽

Cited By ~ 2

Author(s):

Federico Mancini ◽

Gabriele Bernardi ◽

Vincenzo De Luna ◽

Cosimo Tudisco

Keyword(s):

Tendon Rupture ◽

Suture Anchor ◽

Clinical Presentation ◽

Surgical Repair ◽

Suture Anchors ◽

Open Surgical Repair ◽

Repair Technique ◽

Triceps Tendon Rupture ◽

Common Clinical Presentation ◽

Triceps Tendon

Rupture or avulsion of the distal triceps tendon is one of the least common tendon injuries. The most common clinical presentation of the injury is avulsion from the olecranon. The diagnosis of acute triceps tendon rupture may be missed and this can result in prolonged disability.We report the case of a 42-year-old man with isolated triceps rupture treated by an open surgical repair technique involving the use of bone suture anchors.

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Triceps Tendon Anatomic Repair Utilizing the “Suture Bridge” Technique

Journal of Hand and Microsurgery ◽

10.1055/s-0038-1636729 ◽

2018 ◽

Vol 10 (03) ◽

pp. 166-171

Author(s):

David Edelman ◽

Asif Ilyas

Keyword(s):

Primary Repair ◽

Load Resistance ◽

Suture Bridge ◽

Anatomic Repair ◽

Early Motion ◽

Load To Failure ◽

Tendon Ruptures ◽

Triceps Tendon ◽

Suture Bridge Technique ◽

Repair Techniques

AbstractTriceps tendon ruptures are uncommon injuries, but they typically require surgical repair. Multiple primary repair techniques are available, including transosseous, suture anchor, and anatomic repairs. The technique described here, the “suture bridge” repair, provides an anatomic repair of the distal triceps tendon to its footprint. It has the potential advantages of increased load to failure, better footprint coverage, higher load resistance, and allows for early motion.

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Application of suture bridge technique in the treatment of acute patellar ligament injury

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00522 ◽

2020 ◽

Vol 8 (9_suppl7) ◽

pp. 2325967120S0052

Author(s):

Ming Zhou ◽

Wen Zou

Keyword(s):

Knee Joint ◽

Knee Extensor ◽

Postoperative Recovery ◽

Acute Injury ◽

Patellar Ligament ◽

Ligament Injury ◽

Suture Bridge ◽

Ligament Rupture ◽

Bone Fragments ◽

Suture Bridge Technique

Introduction: The patellar ligament, as a knee extensor, plays an important role in knee movement. Patellar ligament tear completely divided into acute and chronic, acute general mishandling lead to fracture again, chronic patellar ligament rupture, need surgery to restore again and device, the integrity of the patellar ligament rupture time more than 2 weeks or more, it’s easy to have a different degree of scar healing, a normal tendinous portion elasticity and tension were significantly decreased, eventually leading to knee disorders. If scar tissue is removed by surgery and sutured again, the required strength of the patellar ligament cannot be provided, resulting in long postoperative recovery time, knee joint dysfunction, muscle atrophy, joint degeneration and other problems. Hypotheses: To explore the method and clinical effect of suture bridge technique in the treatment of acute patellar ligament injury. Methods: From January 2016 to October 2018, 13 patients with Acute injury of patellar ligament insertion were treated with suture bridge technique.Among them, there were 11 males and 2 females, aged from 17 to 35 years, with an average age of 26.3 years.The average time from injury to operation was from 3 to 5 days, with an average day of 3.5 days.Thirteen patients all suffered from closed injury at the inferior end of patella. Among them, 8 had no fracture at the inferior end of patella, 5 had bone fragments and none had avulsion at the tibial end.Thirteen patients all suffered from closed injury at the inferior end of patella. Among them, 8 had no fracture at the inferior end of patella, 5 had bone fragments and none had avulsion at the tibial end.Suture bridge technique was used in 13 cases.Postoperative knee function was assessed by Lysholm score Results: All patients were followed up for 7 to 15 months, with an average of 11.2 months.All incisions healed well, and there were no complications such as infection and re-rupture of patellar ligament.At 6-12 weeks after operation, the range of motion of 13 patients reached the level of uninjured side.According to Lysholm scoring criteria, knee joint function was excellent in 9 cases and good in 4 cases Conclusion: Suture bridge technique in the treatment of acute patellar ligament injury has the characteristics of firm fixation, fewer complications, quick recovery and avoidance of second operation.

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Distal Radius Fracture with Bone Fragment Protruded into the Radiocarpal Joint: Two Case Reports

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835521720164 ◽

2021 ◽

Vol 26 (03) ◽

pp. 460-462

Author(s):

Kaoru Tada ◽

Kazuo Ikeda ◽

Hiroyuki Tsuchiya

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Case Reports ◽

Limited Range ◽

Radius Fracture ◽

Bone Fragment ◽

Dorsal Cortex ◽

Limited Range Of Motion ◽

Radiocarpal Joint ◽

Bone Fragments

Distal radius fractures often involve comminuted fragments of the dorsal cortex of the radius, but bone fragments rarely protrude into the radiocarpal joint. We report two cases of distal radius fracture with bone fragment protrusion into the radiocarpal joint. To the best of our knowledge, there are no English reports of distal radius fracture with bone fragment protrusion into the radiocarpal joint. Despite the rarity of these cases, clinicians should still be mindful of such injuries and not overlook the possibility of presence of bone fragments within the joint. Missed intra-articular fragments may cause pain, limited range of motion, and subsequent osteoarthritis.

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Impairment Tutorial: Rating Tears of the Acetabular Labrum

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2006.novdec02 ◽

2006 ◽

Vol 11 (6) ◽

pp. 4-7

Author(s):

Charles N. Brooks ◽

Richard E. Strain ◽

James B. Talmage

Keyword(s):

Magnetic Resonance ◽

Hip Arthroscopy ◽

Age Groups ◽

Limited Range ◽

Labral Repair ◽

X Rays ◽

Joint Stability ◽

Acetabular Labrum ◽

Complete Excision ◽

Limited Range Of Motion

Abstract The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).

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The Correlation of the Limitations of Movement of the Shoulder Joint with the Functional Ability of Frozen Shoulder Patients at the Medical Rehabilitation Institute Dr. Mohammad Hoesin Palembang

SRIWIJAYA JOURNAL OF MEDICINE ◽

10.32539/sjm.v3i3.218 ◽

2020 ◽

Vol 3 (3) ◽

pp. 88-96

Author(s):

Ine Sintia ◽

Nyimas Fatimah

Keyword(s):

Functional Ability ◽

Shoulder Joint ◽

Frozen Shoulder ◽

Limited Range ◽

Medical Rehabilitation ◽

Cross Sectional ◽

Shoulder Joints ◽

Limited Range Of Motion ◽

Active Flexion ◽

Cross Sectional Design

Background: Frozen shoulder is a condition of the shoulder joint that experiences inflammation, pain, adhesions, atrophyand shortening of the joint capsule resulting in limited motion. In frozen shoulder patients, the limited range of motion ofthe shoulder joint can affect and reduce functional ability. This study aims to analyze the correlation between the limitedarea of motion of the shoulder joint with the functional ability of frozen shoulder patients at the Medical RehabilitationInstallation Dr. Mohammad Hoesin Palembang. Methods: This study was an observational analytic study, correlationtest, with a cross sectional design. There were 29 frozen shoulder patients who met the inclusion criteria in the MedicalRehabilitation Installation Dr. Mohammad Hoesin Palembang in November 2018 was taken as a sample using consecutivesampling techniques. Functional ability was assessed using the quickDASH questionnaire and the area of motion wasmeasured using a goniometer, then analyzed. Results: The results of the correlation test showed significant resultsbetween functional abilities and the area of motion of the shoulder joints. Active flexion (p = 0.000; r = -0.669), activeextension (p = 0.004; r = -0.520), active abduction (p = 0.000; r = -0.663), active adduction (p = 0.022; r = -0.423 ), passiveflexion (p = 0.001; r = -0.589), passive extension (p = 0.002; r = -0.543), passive abduction (p = 0.000; r = -0.676), passiveadduction (p = 0.038; r = -0.388). Conclusion: There is a significant correlation between limited joint motion andfunctional ability in frozen shoulder patients at the Medical Rehabilitation Installation of Dr. Mohammad HoesinPalembang

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Lateral Ankle Instability Surgical Treatment

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000347 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Bahman Sahranavard ◽

Cesar de Cesar Netto ◽

Ashish Shah ◽

Parke Hudson ◽

Ibukunoluwa Araoye ◽

...

Keyword(s):

Surgical Treatment ◽

Revision Surgery ◽

Surgical Repair ◽

Ankle Instability ◽

Primary Repair ◽

P Value ◽

Complication Rates ◽

Suture Anchors ◽

Lateral Ankle ◽

Lateral Ankle Instability

Category: Ankle, Sports Introduction/Purpose: Lateral ankle instability is a common cause of disability in the active population. Although the majority of patients can be treated conservatively, surgical repair of the ligaments, with or without reinforcement, represents an excellent option for refractory cases. Failed primary surgical repair, recurrence of the ankle instability and need for revision surgery can rarely happen and is probably affected by multiple variables. That includes patient’s characteristics such as BMI and comorbidities and surgical aspects such as the use of suture anchors and soft-tissue reinforcement. The purpose of this study was to compare patient’s characteristics and complication rates of primary repair and revision procedures. Methods: We retrospectively reviewed 231 patients (160 Female, 71 Male) who underwent surgical treatment for lateral ankle instability between 2010-2016. Thirty-two were revision cases (14.2%), including 24 females and 8 males, and 199 were primary direct repairs (85.8%). The mean age at the time of the surgery was 39 (19-65)years, and average follow-up was 9 (2-55) months. The procedures were performed by four different surgeons. All cases were reviewed based on age, gender, BMI, procedure type and number of incisions, comorbidities, and complications. Data found was compared between the two groups (primary repair and revision surgery) by T-test. A p-value <0.05 was considered significant. Results: The Brostrom-Gould procedure was used in 69.5% of the primary repairs and 63.6% of the revision cases. The use of suture anchors was also similar in both groups (51%). Repair of the calcaneofibular ligament was performed in 68% of primary repairs and 81.8% of the revisions. We didn’t find significant differences regarding comorbidities between two groups: smoking (23.4% x 27.2%, p-value 0.371); diabetes (6.8% x 6%, p-value 0.951) and body mass index above 30 (28.5% x 24.2%, p-value 0.347). We found significant difference in the complication rate of the procedures, with a higher incidence in the revision group (48.4%) when compared to the primary repair group (24%). That included: sural neuritis (15.1% x 3.4%), superficial peroneal neuritis (12.1% x 4.5%), skin problems (9% x 7.4%). Conclusion: Our study of 231 patients that underwent surgical treatment for lateral ankle instability found significant higher incidence of complications in patients who had revision procedures when compared to primary repair. No differences regarding smoking status, diabetes and BMI were found.

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P080 Acroosteolysis: a rare complication or a co-occurrence with Juvenile Idiopathic Arthritis?

Rheumatology ◽

10.1093/rheumatology/keab722.072 ◽

2021 ◽

Vol 60 (Supplement_5) ◽

Author(s):

Makhlouf Yasmine ◽

Miladi Saoussen ◽

Fazaa Alia ◽

Sellami Mariem ◽

Souabni Leila ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Psoriatic Arthritis ◽

Rare Complication ◽

Plain Radiograph ◽

Limited Range ◽

Acute Phase Reactants ◽

Limited Range Of Motion ◽

Macular Rash ◽

Oligoarticular Juvenile Idiopathic Arthritis ◽

Dysmorphic Syndrome

Abstract Background Acroosteolysis refers to a destructive process involving the distal phalanges of the fingers and toes that may extend to metacarpals or metatarsals. Rarely idiopathic, the diagnosis of primary acroosteolysis requires ruling out other causes. Juvenile idiopathic arthritis is an exceptional aetiology of acroosteolysis occurring mainly in psoriatic arthritis. Here by a case of juvenile idiopathic arthritis associated with acroosteolysis of the toes. Methods A 13-year-old girl with no past medical history, presented to our department of rheumatology with oligoarthritis affecting both wrists and knees. She had no familiar history of psoriasis nor rheumatic diseases. She described a dull ache and recurring swelling of knees evolving for >6 years associated with a macular rash of the chest without fever. On examination, the knees were swollen with a limited range of motion of < 90°. Examination of the spine and sacroiliac joints was unremarkable. There was no deformity, no dysmorphic syndrome nor ligamentous hyper laxity. The mucocutaneous examination was normal. Similarly, there was no hepatosplenomegaly or swollen lymph nodes. Laboratory investigations showed high acute phase reactants and normal blood count. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies and antinuclear antibodies were also negative. Besides, she was negative for HLAB-27. Ophthalmic examination did not show any sequelae of uveitis. Results Plain radiograph of the feet revealed bone resorption of the second and fifth distal phalanges without signs of reconstruction. Other secondary causes of acroosteolysis were ruled out. The diagnosis of oligoarticular juvenile idiopathic arthritis was made. In view of the involvement of the distal phalanges, the phenotype of psoriatic arthritis was probable. The patient was initially treated with non-steroidal anti-inflammatory drugs as well as intraarticular injections of corticosteroids in knees. As the flares persisted, she was put on Methotrexate at a dosage of 15 mg per week with marked clinical improvement. Conclusion Our case illustrates a possible occurrence of acroosteolysis of the feet in the field of an active juvenile idiopathic arthritis. It is important to rule out other causes and make a rapid diagnosis in order to ensure appropriate management decisions.

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Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review

Case Reports in Orthopedics ◽

10.1155/2018/1901235 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Koichi Yano ◽

Yasunori Kaneshiro ◽

Hideki Sakanaka

Keyword(s):

Lateral Collateral Ligament ◽

High Energy ◽

Limited Range ◽

Forearm Rotation ◽

Collateral Ligament ◽

Lateral Epicondyle ◽

Limited Range Of Motion ◽

Contracture Release ◽

Normal Congruence ◽

The Right

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.

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